Universal access
to scientific and technical information in health (stih) is a requirement
for health development. In other words, relevant and opportune stih must
subsidize the actions and procedures involved in decision making related
to health planning, administration, research, education, promotion and
care.
To seek a scenario, in
which health-related decision making is more efficient because it is based
on stih, is an enormous challenge to developing countries, specially,
those in Latin America and the Caribbean. Cooperation among countries,
through the national and regional institutions that produce, mediate and
use information is indispensable to overcome this challenge.
The Virtual Health Library
is PAHO's proposal for promoting and operating technical cooperation with
the countries and among countries aimed to attaining the goal of equal
access to stih.
The VHL proposal was presented
by BIREME at the VI Meeting of the Latin American and Caribbean System
on Health Sciences, held in San Jose, Costa Rica, during the IV Pan-American
Congress of Information on Health Sciences, the week of 23-28 March 1998.
The proposal received unanimous approval from the System representatives
and the San Jose Declaration Towards the Virtual Health Library was approved.
This paper is identified
as a guide because it retakes the VHL proposal and, based on the experience
obtained from its development over the last year and a half, it offers
a series of details, interpretations and guidance for building a network
of information sources as well as the VHL development strategy. It particularly
reaffirms the VHL as a new paradigm of cooperation and handling of technical
and scientific information on health in the Region, the adoption of which
requires new forms of organization and operation to promote active participation
of producers, intermediaries and users of information on health.
2. Building a network
of information sources for the VHL
The VHL is founded on the
information paradigm established by the Internet in which a user can interact
directly with networks of information sources as well as with other users.
Thus, the VHL is conceived
as a network of stih sources, operated on the Internet in a cooperative
manner by countries in the Latin American and Caribbean Region. For the
next few years, PAHO stih technical cooperation, coordinated by
BIREME's, will concentrate on building and operating a network of VHL
information sources.
As a Library, the VHL is
a decentralized and dynamic collection of information sources aimed to
availing democratic access to scientific information on health. The collection
is operated as a network of products and services on the Internet, in
order to progressively fulfil the health information needs of authorities,
administrators, researchers, teachers, students, professionals, technicians,
media and general public. The VHL stands out among other sources of information
on the Internet because of its high level of criteria in selection and
quality control. In establishing a site on the Internet, the VHL contributes
towards solving the problem derived from the great dispersion of information
sources on the Internet and the limited reliability of retrieval procedures.
It also contributes to minimize duplications resulting in resource economy
and reduced inconsistencies.
To more easily understand,
organize, implement, establish priority and decentralize operations of
the VHL information sources, they are classified in six major categories
described below. Within the VHL universe, an information source is defined
as any information resource, product or service, as well as an individual
or community of individuals, that attends to the VHL user’s information
requirements
Here are included the
production and dissemination in the VHL of national and international
bibliographic references, directories of health-related entities and
events, factual databases and numerical databases.
The network of databases
integrated in the LILACS system stands out among other bibliographic
databases, registering a collection of scientific and technical literature
on health-related matters, including legislation, produced by countries,
as well as regional and sub-regional organizations. The LILACS database
system in the VHL must ensure that over the next few years it will offer
the Region universal and visible access to scientific technical literature
on health.
Bibliographic inputs
will be enhanced progressively with links that allow locating authors
and institutions as well as complete referenced texts. The LILACS system
is complemented by providing access to international databases, such
as the varied versions of MEDLINE. The VHL counts on its common retrieval
interface iAH for operating bibliographic databases, which is public
domain among the institutions that operate the VHL. Associated to bibliographic
databases, the VHL operates SCAD – Service for Accessing Documents that
allows online operation of all transactions to access an original document.
The system that operates SCAD is integrated with the iAH interface.
In this manner, over the next years, it will be possible to access complete
texts in the bibliographic database, either via connections to electronic
texts, and/or electronic copies of paper documents.
Within the VHL, the directories
include, among others, information of institutions, specialists, projects,
events (conferences, seminars, etc.), courses, etc. with the objective
of being more efficient in locating, referencing, documenting, creating
networks and evaluating the players, activities and events related to
health areas. Records of these directory databases allow the establishment
of connections with other VHL sources of information aimed at molding
a space integrating events, players and authors with other VHL sources
of information. The directories are operated in a decentralized manner
and networked in the VHL. The VHL has public domain systems to operate
the directories, which should be progressively improved to fulfill increasing
requirements related to content as well as access and navigation capacity.
Over the next years, operating the directories will allow a high degree
of efficiency in all tasks that demand relating players
and events in fields related to health.
Numerical databases include
different sources of information generated by health management information
systems, vital statistics systems, epidemiological surveillance, surveys
and demographic censuses, etc. These information sources should be consistently
enriched with connections to other VHL sources of information, especially
scientific literature and other products and services related to decision-making.
Factual databases on the
VHL will operate information on chemical substances, health related instruments
and technology, experiments, case studies, etc. Information in the factual
database will consistently be enriched with links to bibliographic records,
directories, etc.
Electronic publications
include the operation in the VHL of national and international health
related electronic full texts of scientific and technical literature.
The VHL operates online
electronic publications of all types of scientific technical literature
entered in the LILACS database system, including scientific journals,
monographs (including books), theses, government documents, documents
prepared by PAHO and other regional organizations, papers presented
at congresses, manuals, guidelines, epidemiological bulletins and legislation.
Bibliographic records of the LILACS system databases will be linked
to these full texts.
Progressively, scientific
journals will be published online, using SciELO Methodology, which offers
advanced and efficient procedures to prepare, store, publish, save and
evaluate electronic scientific publications. National and regional SciELO
sites on the VHL will operate the highest quality scientific journals
from countries in the Region. As a consequence of the development of
SciELO sites, visibility and access of Latin American and Caribbean
scientific production will increase radically.
On the other hand, SciELO
Methodology will gradually be applied to other types of literature,
with the objective of developing a network of electronic publication
collections covering all relevant publications produced by health institutions
in the Region. The main institutions that produce stih, including
Ministries of Health and other governmental entities, research and educational
institutions, etc. should preferably develop electronic editorials (stored
in integrated electronic publication sites) with the objective of efficiently
organizing and controlling the quality of their own publications to
facilitate retrieving, saving and operating within the VHL network.
Continuous expansion
of national communication networks makes it easier to access international
scientific publications, especially scientific journals published on
the Internet. Access to collections of subscription scientific journals
should be set up in a consortium to allow for maximization of the number
of users per dollar invested by national institutions. These well-established
consortiums in many developed countries, are ideal forms of strategy
in negotiating and operating subscriptions to scientific journals. Application
of the consortium format should be disseminated in our countries with
a view to optimizing the use of national resources, including demands
of lower prices for developing countries. The focal point is no longer
possessing the journals, but having access to them.
On the other hand, the
recent initiative of the National Institute of Health and the European
Molecular Biology Organization to operate in the near future open access
databanks of scientific health-related articles on the Internet will allow
democratic access to international scientific production. With the development
of SciELO scientific journal sites, the Region will be able to access
a wide volume of complete texts online.
c. Information
sources in support of education and decision-making
This category includes
an ample spectrum of information sources of didactic nature and/or directed
at the decision-making processes in health-related matters.
In support of education
in health sciences, the VHL considers the development and operation
of collections of electronic texts and multimedia with free access on
the Internet and/or on the Intranets of educational institutions. These
collections should support traditional courses or distance education
formats. Included here are graduate and postgraduate courses, such as
specialization courses, continued education courses, short courses for
professionals and technicians, courses directed at the general public,
etc. Development of a network of education support sources will allow
these information sources to be used by innumerable courses, perfected
in content and form, expanded in reach, inter-related, etc., thus, avoiding
duplication and scattering. In a few years time, the VHL will become
a common site of excellence for producers, intermediaries and users
of educational support material. The VHL will also contribute to the
evaluation processes of the different systems and methodologies applied
to distance education.
With reference to development
and operation of information sources to support health-related decision
making, the VHL proposal includes different contexts, situations and
users, such as authorities, management, scientists, professors, health
professionals and the public in general. Included here are text and
multimedia scientific dissemination, targeted at specific publics and
situations, numeric indicators, manuals, professional practice and general
public guidelines, consensus statements based on evidence, case studies,
experience reports of experiments that may be repeated or should be
avoided, collections of answers to most frequent questions covering
specific subjects, interviews to specialist, material to support public
online consultation services, telemedicine practice, material to support
situation rooms, etc.
In a manner identical
to the strategy applied to information sources in support of education,
the VHL foresees developing a network of information sources in support
of decision-making that would stimulate its reuse, improvement, expansion
and inter-relation to avoid unnecessary duplication. Building and operation
of this information sources network in varied contexts will definitely
contribute to a scenario in which the decision-making processes in health
related matters will bank on relevant and opportune technical scientific
information.
VHL construction and operation
does consider the continual development of public domain methodology and
instruments to prepare, store and spread information sources in support
of decision-making.
VHL offers selective information
dissemination, that is a service aimed at alerting subscribers to new
sources of information included and/or referenced in the VHL, according
to predetermined thematic profiles. As the volume of information held
by VHL increases, this service will become increasingly important based
on its objective of enhancing user time worth.On
the other hand, the selective information dissemination service will increase
visibility of the information sources as they become integrated and/or
referenced in VHL.
The VHL will develop a network of profiles or specializations aiming at
efficiently answering the professional updating needs of specialized communities,
or of those interested in specific subjects. The profiles will be adjusted
as they are used. User subscriptions to selective information dissemination
services, as well as recommendations and/or definitions of new profiles
will be processed online. Alerts will be sent to users via Internet services
such as e-mail, web or PUSH.
SDI services should be used to attend to user
communities that are not connected to the Internet through intermediary
agents.
One of the basic characteristics of the Internet paradigm is intensive
and fast communication among people and establishment of virtual communities
centered on specific matters or interests. It is characterized by means
of communication directly operated by the user who has been given the
power of initiative and the capability to directly operate data source
networks without imposing time and space limitations. The VHL construction
is based on this paradigm.
Within the VHL, communication encompasses stih information sources that
promote and establish direct and indirect communication among users. Included
here, for example, are listings of debates, teleconferences, online interviews,
forums, specialist consultations, etc. The VHL will operate and reference
the communication information sources. Communication also includes information
sources both in news and news clippings format.
f. The VHL integrating components
Integration and definition of the VHL space as well as outside source
referencing is given by the use of DeCs vocabulary –Descriptors in Health
Sciences, LIS – Health Information Locator, and other methodology common
to information sources. The VHL space is defined by network operation
of decentralized information sources.
The network is established, on one hand, by either static or dynamic predetermined
links among information sources and, on the other, by responses from the
information sources to content search and navigation. In the latter case,
the network construction is based on the data source’s capacity to respond
to content requests.
Use of terminology or predetermined vocabulary to describe overall information
sources and the information they contain is the mechanism VHL applies
to maximize response capacity to content requests. VHL controlled vocabulary,
DeCS – Descriptors in Health Sciences is operated in a three-language
database– Spanish, Portuguese and English. DeCS terminology and structure
is based on MeSH (Medical Subject Headings) from the National Library
of Medicine (NLM), which allows its participation with Spanish and Portuguese
terms in the Unified Medical Language System - UMLS of the NLM. The DeCS
contains over 25,000 entries, including terms from MeSH and terms included
by BIREME to describe/retrieve information sources in public health and
homeopathy. The public health area contains over 6,000 terms and covers
specific areas, such as, health service administration and health sector
reform, areas of environmental sciences with sanitation engineering terminology,
environmental health, natural disasters or disasters brought about by
mankind, etc.
Directories that reference internal and outside information sources to
the VHL space are operated with LIS – Health Information Locator. LIS
allows description and retrieval of information sources in a manner compatible
with international standards. It also allows operation of directories
covering varied geographic areas – divisions of a country, groups of countries
within and without the Region. It is also possible to restrict operation
to thematic areas. The VHL assumes there will be a national directory
by country that will selectively reference national sources of technical
scientific information in health. There will also be a regional directory
that BIREME will operate. LIS will therefore allow retrieval of all information
sources that form the VHL space.
The third VHL integrating component is composed by common methodologies
used by stih producer and intermediary institutions. The methodologies
include directories, norms, manuals, registration forms, basic and application
software, etc. Use of common methodologies increases possibilities for
exchange, static and dynamic links, navigation, evaluation, etc. among
information sources. It also facilitates training of human resources and
contributes toward less costly instruments. The VHL has a series of public
domain methodologies to operate the diverse information sources. This
area in the VHL needs constant development since construction and operation
of the VHL continuously requires preparation of new methodologies and
improvement of existing ones. The producer, intermediary and user institutions
are responsible for contributing to the development of the VHL collection
of common methodologies.
The initially isolated development of one or more of the various information
sources described above by the institutions producers and intermediaries
of scientific technical health information oriented towards a community
of users within specific countries in the Region, result in generation
of nodes in the VHL network of information sources.
Initially the nodes are scattered, but, in time, their increase will allow
users larger capacity to use and promote interaction between sources of
information and, consequently, demand and stimulate new nodes to appear
in reply to old and new information requirements. The major challenge
in building the VHL lies in creating this type of dynamics. Therefore,
a line of action is proposed to promote massive realignment of the existing
information products and services in the countries to operate as VHL information
sources. As the number and potential for interaction among information
sources increase, a VHL virtual space begins to mold, in which users will
build and update responses to their information demands.
VHL operation demands quality control for the insertion and maintenance
of information sources as well as for references to external information
sources. The criteria applied must be improved continually as an integral
part of VHL development, likewise, the evaluation results of information
sources use and impact. As a general policy, evaluation criteria are based
on source authorship and/or revision process and explicit approval by
those responsible for its operation in the VHL. Development and improvement
of criteria, policies and procedures to evaluate and select information
sources are defined and applied by the VHL Consulting Committees that
operate on a national level and on subject areas. The VHL should, in the
future, have a network of specialists to revise and approve information
sources.
Active user participation should be integrated in the data source operational
interfacing with the objective of expanding quality control and promoting
information source improvement.
A different aspect of the VHL network construction that merits attention
is the methodology (directories, manuals, standards, formats, basic and
application software, etc) applied to the operation of information sources.
Development of the VHL continuously requires new methodologies as well
as improvement of existing methodologies, this is stimulated by the need
to increase user interaction power and incorporate international advances.
To attend this demand, VHL producers, intermediaries and users should
join BIREME in setting up a network of methodology developers. In this
regard, BIREME has recently undergone very positive experiences in developing
DeCS in cooperation with the Biblioteca Central de la Facultad de Medicina
at the Universidad de Chile and jointly developing LIS with Infomed at
the Centro Nacional de Información de Ciencias Médicas in Cuba.
Finally, it is important to stress that the VHL, as a data source network
operated on the Internet, assumes the existence of a network of agents
to go between individual users and users communities not connected to
the VHL space. Libraries, documentation centers, community centers, cafés
connected to the Internet, public Internet access kiosks and others, can
make the VHL information sources accessible to communities not connected
to the Internet. This strategy will also contribute to increase the demands
for access and expansion of the Internet structure. The existence and
operation of such a network of intermediary agents reinforces the strategy
aimed at attaining equality in access to stih and counters all the incorrect
interpretations that state the advanced VHL concept is elitist.
3. The VHL as a paradigm of Scientific
and Technical Information in Health
Producers, intermediaries and users of stih are availed common virtual
space in the VHL that allows for decentralized operation of information
sources. While the space is common, the VHL is structured with compatible
methodologies, including the application of selection and quality control
criteria that sets it apart from other sources of information on the Internet.
In this manner, the VHL assures development of a reliable space, in which,
on one hand, producers and intermediaries can offer their products and
information services, and, on the other, users interact or navigate through
sources of information that will adequately respond to their information
requirements. Also, constructing and operating the VHL generates conditions
that allow institutions and the community of health professionals in the
Region to access and intensively use advanced information technologies.
The VHL represents a space in which to link and progressively join know-how
among producers, intermediaries and users of stih within the Region and
within the Internet paradigm.
Constructing and operating the VHL means that in the near future a series
of problems and limitations in the stih technical cooperation format used
over the last ten years will be overcome successfully by the Latin American
and Caribbean System on Health Sciences Information. In particular, the
VHL will overcome limitations on space, time, size and up to date nature
of the collections available in information sources, especially those
supported by printed material available to the community of health professionals
in the Region through libraries and traditional document storing facilities.
Overcoming these limitations through the VHL is a condition essential
for supplying the wide scope of health information users with the capacity
to directly access the collection of updated and relevant information
sources in the Region and fulfill their requirements.
However, adopting and implementing the conditions and operation format
characteristic of VHL represents an enormous challenge to institutions
in the Region that produce and intermediate stih. The challenge is particularly
applicable to the ten-year old operation format of institutions, libraries
and information centers that integrate the Latin American and Caribbean
System on Health Sciences Information, that must undergo profound renovation
and expansion, especially:
-network operation of information sources in electronic format within
the Internet/VHL, which requires mastering of advanced methodology and
information technology by managers and technicians at stih producer institutions,
intermediaries and users;
-Expansion of the array of alliances that mainly involves converging data
producers and intermediaries. There is a radical disintermediation process.
On one hand, direct interaction between user and information sources is
predominant. On the other, a demand for organized preparation and publication
of information sources that enhances user time worth.
Overcoming these challenges is intrinsic to the VHL. That is, in regard
to technical cooperation programs, the VHL includes in addition to the
construction and operation activities, the very process of learning and
creating its own development capability. In other words, decentralized
construction of the VHL will enable countries in the Region to learn new
information and communication technologies.
It is important to note that the change represented by Internet in general,
and the VHL in particular, is unavoidable! The stih Producers and intermediaries
that do not promote this change in their modus operandi will cease to
efficiently cater to their users needs and will jeopardize their own survival.
Resistance to change on the part of stih producers and intermediaries
bent on maintaining obsolete operational formats, will translate into
penalizing the community of users that, contrary to the international
trend, will be subject to limitations in their access to information sources
in the Region. However, it is also important to note that the classic
principles that govern the mission and work of libraries and information
centers remain valid and even more explicit as society uses information
more intensely. It is worthy noting that this is the main reason behind
the Library’s denomination as the Virtual Health Library.
Changes brought about by adopting the VHL, primarily and fundamentally
affect and demand response by managerial and technical human resources.
Adoption of the VHL format by managers and technicians is essential for
institutions to renew adequately and opportunely their organizational
structure and their information sources and technology infrastructures.
Controls represented by structures, policies, procedures, interests and
conventions that in practice represent resistance or obstruction to implementation
of the VHL format should be re-evaluated, made flexible and/or eliminated.
In the particular cases of BIREME and the Latin American and Caribbean
System on Health Sciences Information, which congregate health libraries
and documentation centers in countries of the Region, there is a tradition,
developed over the last three decades, to renovate and overhaul obsolete
formats of organization and data processing. Some historical examples
are pioneer de-centralization of automated cooperative bibliographical
control through the LILACS system database, cooperative access to documentation,
and early implementation of CD-ROM technology at the end of the 1980’s,
which allowed local access of countries in the Region to the LILACS and
MEDLINE databases for the first time. A more recent example is the unanimous
and enthusiastic approval of the VHL proposal presented by BIREME in March
1998 at the VI Meeting of the Latin American and Caribbean System on Health
Sciences via the San Jose Declaration towards the Virtual Health Library.
Therefore, there are examples and experiments contributing to the adoption
of the VHL for operating sources of scientific and technical information
in health within countries in the Region. In particular, all BIREME/PAHO
action in promoting and undertaking technical cooperation is centered
on building and operating the VHL.
The way to the VHL, meaning the processes for disseminating, adopting,
developing and operating the VHL, can be seen and analyzed as traced by
two main guidelines. The first guideline refers to VHL development in
time, that is, the implementation periods or scenarios to be developed
over the next five years. The second directional guideline refers to the
organization, planning, fund raising and working levels and spaces involved
in implementing the VHL, highlighting its focus on geographical and subject
areas.
The way to the VHS considers three major periods or scenarios:
- In the current period, between 1999 and 2000, the scenario entitled
"implementation of the VHS" predominates. Basically, it implies adopting
the paradigm, arranging, and coordinating collaboration among producers,
intermediaries and users in order to start the cooperative operation of
information sources, especially, realigning stih products and services
already in existence to conform to VHL context. Implementing the VHL is
a priority and it occurs simultaneously in geographic and subject areas.
During this period, promotion and training activities characterize technical
cooperation activities.
- Between 2001 and 2003, the scenario entitled "the VHL builds momentum"
predominates. Its main characteristics are strengthening and expansion
of decentralized nodes of data source networks and the emergence of the
VHL virtual space. During this period, a significant increase in the number
of new institutions and/or information sources independently incorporated
to the VHL should occur, both in geographic and subject areas. During
this period, promotion and frameworks for the emergence of independent
initiatives characterize technical cooperation activities.
- Finally, as of 2003, the predominant scenario is the VHL presented as
(auto) reference for stih sources in the Region, with the fundamental
characteristic of consolidating VHL virtual space as a common meeting
ground for health information producers, intermediaries and users. During
this period, technical cooperation on scientific technical information
acquires its own dynamics, which is coincident with the dynamic profile
of the VHL itself.
The second VHL directional guideline promotes development of decentralized
information sources, geographical (covering national, subregional and
regional dimensions) and by subject areas.
- Geographically, the VHL foresees and requires participation of all countries
that will progressively operate their own information sources in a compatible
manner and in network with other countries. During this phase, technical
cooperation will be characterized by development of national capability,
including the generation of more advanced and efficient coordination and
organization formats to enable ample and active participation in the VHL
of information producers, intermediaries and users. In this sense, an
important aspect of technical cooperation consists in establishing and
operating national Consulting Committees to coordinate national participation
in the VHL as well as preparation, implementation and follow up of national
plans for VHL implementation, particularly during the VHL implementation
phase. In order to utilize synergetic power between groups of countries,
technical cooperation projects and programs should be implemented among
the countries.
- By subject areas, the way to the VHL uses potentials, strengths, capabilities,
resources and initiatives that characterize information structures within
health related subjects that favor creation, development and efficient
operation of specialized health data networks, a large number of which
should emerge, especially during the VHL implementation phase. PAHO Regional
Programs and specialized Centers have a fundamental role in promoting,
implementing and operating subject areas in the VHL, at regional and sub-regional
levels. Thus, for instance, CEPIS should play a leading role in technical
cooperation for developing the environmental health area, INPPAZ for food
protection and zoonoses, INCAP for nutrition, CLAP for perinatology, etc.
Other regional institutions directly or indirectly connected to health
related subjects will also be called upon to integrate the VHL. Nationally,
development of specialized areas within the VHL should include active
participation by governmental institutions, especially health promotion
programs, research centers, professional and scientific societies, non-governmental
organizations, etc.
Geographical and by subject areas development of the VHL is complementary.
In both cases, VHL implementation plans should consider or be guided by
the implementation phases or scenarios programmed to occur within the
next five years.
Overall, the VHL will form its virtual space by integrating decentralized
progress geographically and by subject areas. Thus, it will be possible
to navigate the complete network of information sources in the Region,
from within the VHL space.
5. Organization and planning for
implementing the VHL
The VHL is being implemented in the Region, both geographically and by
subject areas, and in accordance with the specifications in the basic
VHL document, particularly, in the "Action plan to implement the VHL."
BIREME has implemented the VHL at the Regional level and has cooperated
in its decentralized development with national and regional institutions.
VHL dissemination activities were undertaken during 1998 and 1999, in
practically all countries in the Region. VHL implantation was successfully
implemented in several countries and subject areas especially in regard
to realignment of existing products and services.
Initial VHL implementation activity shows that the proposal has extraordinary
receptivity in every area and the advances made in certain countries and
subject areas confirm the VHL feasibility. The institutions within the
Latin American and Caribbean System on Health Sciences Information have
played an important role in these advances. It is also true that many
countries face major difficulties in implementing the VHL. Indicators
of these difficulties are the delays, resistance, lack of political decision
and support, scattered institutions or inability to adopt the VHL paradigm.
All these, as previously stated, require the operation of information
sources on electronic format via the Internet/VHL and getting producers,
intermediaries and users to work jointly within the VHL.
BIREME strongly recommends that development of the VHL at national level
and by subject areas should have from the very beginning the support of
Consulting Committees and implementation and development plans. An active
Consulting Committee that congregates the main stih agents in a country
or covers a certain subject area is one of the (pre) conditions for efficient
and sustainable development in adopting and operating the VHL. A second
condition is to be able to rely on a national plan to direct the VHL within
a country or subject area, initially concentrated in organizing the two
scenarios for the following years, which are "implementing the VHL" and
"the VHL builds momentum".
Setting up a Consulting Committee in a country or about a subject area
is generally preceded by a discussion among representative institutions
about stih producers, intermediaries and users. The discussion contributes
to understanding the overall VHL proposition and its implications, tanking
into consideration the conditions and contexts within which it will be
adopted.
The national or subject Consulting Committee should congregate representatives
from the main institutions of producers, intermediaries and users of technical
scientific information in the country or on the subject area. Included
here are Health Ministries and related entities, educational and research
institutions, national science and technology committees, scientific and
professional societies, groups of scientific editors, as well as libraries,
documentation centers and information networks and systems. Especially
included are the National Coordinating Centers, the Specialized System
Coordinating Centers and the cooperating centers that integrate the Latin
American and Caribbean System on Health Sciences Information. The role
these centers play in establishing and operating the Consulting Committees
can vary considerably, according to local conditions and contexts. The
centers can assume leadership in arranging and setting up the Committee
or play an important or passive role in the process. It is important to
note that, with rare exceptions in small countries, no isolated center
is capable of fully operating stih information sources of a country or
subject area. Furthermore, the very essence of the VHL is the decentralized
information sources operation.
The role of the Consulting Committee is to assure active and equal participation
of all institutions interested in constructing the VHL. Furthermore, the
Committee establishes guidelines, strategies and criteria for the VHL
operation according to national priorities and conditions, or by subject
areas. Committee discussions and recommendations should guide the VHL
operation. The institutions whenever possible should be represented in
the Committee by authorities, managers and technicians as a way to make
their political goals compatible with the technological conditions and
applications.
Activities related to organizing, establishing, documenting and working
the Committee should have the support from one or more institutions. Candidates
to play these roles are the institutions that form the national health
science information network system. It is always advisable that several
institutions play this role and in certain cases relayed work mechanisms
can sometimes be established. PAHO representatives in the country, as
well as PAHO Specialized Centers can undertake an important role in establishing
and operating Consulting Committees.
Consulting Committees should be formalized and legalized as part of the
consolidating procedure.
Consulting Committees should have active participation in the debates,
preparation, implementation, follow-up and evaluation of the VHL national
and subject area development plans. Policies, strategies, guidelines and
priorities for establishing future VHL scenarios are defined during the
planning stage. Implantation of the plans must be decentralized, and placed
under the responsibility of institutions that may be integrated or not
in the Consulting Committees. Plans should be flexible and subject to
reformulation so they do not impose restrictions to VHL development.
BIREME recommends that plans be translated or developed by means of specific
projects targeted at creating, developing and operating the VHL information
sources. Specific projects make it easier to define priorities according
to needs and available resources, as well as distributing the responsibilities
and networking. Specific projects are undertaken by one or more institutions
and the project distribution criteria should consider institution efficiency
and subject area. Some important aspects are derived from the formulation
of possible specific projects targeted at the VHL. First, it is impossible
for one institution to take total control of the complete process. Second,
resources to undertake the work are limited, which implies the need to
define priorities and establish restrictions. Third, the collection of
projects can be undertaken as a portfolio of projects when negotiating
financing by national and international agencies.
As a contribution to formulating national plans and specific projects,
during 1999, BIREME has worked with the following list of project lines,
all of which derive from six types of information sources within the VHL
framework.
a. Main national page or Main subject area page in the VHL
The specific objective of this line of projects is to set up and operate
the main page of a country or subject area (at national or regional levels).
The main page is the entrance door or integrating point of related information
source networks. Another important role played by the main page is to
register news and statistics on the development of the information source
network.
b.Technical scientific literature
The specific objective of this line of projects is to operate technical
scientific literature information sources related to the project. It covers
an ample range of activities and information sources. It is advisable
to divide it into several projects, including, for example, (1) Bibliographic
control of literature based on the LILACS database System; (2) Bibliographic
control of legislation integrated in the LEYES database; (3) Online operation
of bibliographic databases; (4) Online operation of library monograph
directories; (5) Online operation of a "books in print" directory; (6)
Audiovisual directory; (7) Directory of health sciences series (SeCS);
(8) Cooperative access service to documents (SCAD); (9) Development of
consortiums for cooperative access to international collections of scientific
journals; (10) Development of collections of electronic scientific journals
(SciELO); (11) Development of electronic editors at producer institutions.
c. Directories of institutions, specialists, projects, courses, events,
etc.
The objective of this line of projects is the operation of health-related
entities and events within the VHL. It can be divided into several projects
each aimed at guiding to a type of entity or event, such as, (1) institutions;
(2) specialists; (3) research projects; (4) courses; and (5) events.
d. Support to decision-making procedures
The objective of this line of projects is the operation of information
sources that support varied decision-making procedures. The scope of this
line is very wide. Therefore, it must be divided into several projects,
the implementation of which will be undertaken by specific institutions
and communities, since the information sources must be placed in context
relating to content, form and operation. During the VHL implementation
phase, the development of specific projects aimed at different segments
of public is recommended, including health administrators of the national
health systems at various levels, health professionals and the general
public.
e. Support to health education
The objective of this line of projects is the operation of information
sources in support of the different health education programs, including
regular courses in health sciences, continued education, courses targeted
at the general public, etc. This line of projects is very ample in scope
and its set up and development depend on mobilizing related institutions.
There is, for example, a demand for experimental support projects, with
information sources for distance education. Other projects should aim
at getting faculties to publish teaching material from their regular courses
in their Intranets or the Internet, and that scientific and professional
societies publish supporting teaching material for continued education
courses.
f. Selective information dissemination
The objective of this line of projects is the operation of selective dissemination
of national and by subject areas information services. Included here are
services to connected and unconnected user communities.
g. Communication: news, list of debates, teleconferences
The objective of this line of projects is the operation of information
sources aimed at divulging information to different communities about
health related events, as well as stimulating communication among individuals
by means of lists of debates, forums, specialist consultation, teleconferences,
etc. An important project within this line of projects is the development
of human resources and technology infrastructures to operate these new
communication technologies.
The objective of this line of projects is to disseminate and develop a
DeCS vocabulary to support operation of other information sources, including
description and retrieval of entries contents and information sources.
Training courses, and subject area creation and revision are included
here.
i. The VHL exhibitions and seminars
The objective of this line of projects is to hold exhibitions, seminars,
conferences, fairs, etc. within the VHL, on subjects of interest for the
development and updating of specific communities and the general public.
This virtual events can be held twice or 3 times a year and undertaken
by one or several specialized institutions related to the central subject.
The objective of this line of projects is the operation of directories
listing information resources on health at national, regional and international
levels, of either a general range or restricted to a certain subject area.
Each country should have at least one LIS project aimed at assuring that
the national technical scientific information resources available on the
Internet are entered as references in the VHL. Some aspects to be investigated
and tested in this line of projects are the establishment and improvement
of quality control criteria and mechanisms, the integrity of the references
and links, and the decentralized and automatic data input.
In its technical cooperation program for the year 2000, BIREME will give
priority to activities related to promoting and developing Consulting
Committees on different instances, as well as preparing development plans
of the VHL. At the same time, an intensive program of training courses
for operating the VHL, directed at producers, intermediaries and users
will be undertaken. As a result of these courses, BIREME will set up a
network of VHL monitors to multiply the training courses.
VHL construction and operation assumes the observation of a series of
principles derived from its conception and its condition as a space for
promoting and undertaking technical cooperation in stih aimed at availing
all countries in Latin America and the Caribbean equal information access
to health related information.
The governing principle is the search for equity in the VHL development
and operation, as an expression of the commitment aimed at attaining equity
in stih access. By applying this principle to different geographic contexts
(including countries, sub-regions, and the Latin America and the Caribbean
Region as a whole), and within the different contexts defined by subject
area, the VHL, as it develops, must ensure that all entities directly
or indirectly related to stih be availed the opportunity to participate.
Here lies the reason this paper has attributed importance to the formation
of Consulting Committees as a means of promoting the principle of equity
in development and operation of the VHL.
The second principle emphasizes that policies and actions for adopting
the new paradigm must have priority. It is directed in essence at the
current VHL phase, "implementing the VHL." As a consequence of this principle,
technical cooperation activities, information policies definition and
application, resource application, etc. as related to stih, must be guided,
whenever possible, to adopting the VHL paradigm. Since the new paradigm
points to expansion of the capacity to disseminate information, observance
of this principle contributes to increasing efficiency in terms of future
returns when applying financial resources. On the other hand, this principle
also contributes to feeding debate and actions aimed at overcoming resistance
and barriers imposed for adopting the VHL.
The third principle calls for priority to be given to policies and actions
to promote and establish alliances and consortiums. This principle guides
the VHL development towards maximizing shared use of resources directly
or indirectly related to stih, available in a country, sub-region or the
Region as a whole. Application of this principle also contributes towards
accelerating the VHL development by generating synergy between diverse
entities. Observance of this principle contributes to reduce inefficient
and destructive competition among and within participating institutions.
The fourth principle derives from the very conception of the VHL and is
directed to decentralize operation at all levels. It is important to understand
that the objective of this principle is to promote equal participation
at all levels of the VHL operation. Furthermore, it does not prohibit
centralized operation when it is more efficient and safe and relies on
the support of all parties involved. The principle also stresses the necessity
to stimulate institutions to also dedicate work to developing methodology
to construct and operate the VHL.
The fifth principle guides VHL development based on local conditions and
it is very important because it opens the door for all interested parties
to participate. This principle applies to political, social, economic
and cultural conditions within which the VHL develops, and to infrastructure
conditions of stih resources, telecommunication and human resources. The
principle applies equally to privileged and unprivileged participating
institutions insofar as access and ownership of resources is concerned.
The last principle is aimed at establishing and applying integrated mechanisms
for evaluation and quality control in the decentralized operation of information
sources, targeted at promoting the reliable and trustworthy characteristics
of the VHL space.
